A qualitative exploration of the unique challenges facing older men with haemophilia and the implications for social work practice


  • Sarah Eleanor Elliott University of Auckland
  • Kelsey L Deane University of Auckland
  • Barbara Staniforth University of Auckland




Keywords, Haemophilia, ageing, social work, wellbeing


INTRODUCTION: For the first time, people who have haemophilia are facing the same aging issues as the general population, adding further complexity to their care and treatment. Worldwide, there has been little research on the psychosocial effects of growing older with haemophilia. This study investigated the holistic experiences of older men with haemophilia in Aotearoa New Zealand. Support services, particularly the roles that social workers could play in facilitating wellbeing, have also been explored.

METHODS: A focus group was conducted with a purposive sample of five older men living with haemophilia in Aotearoa New Zealand. Thematic analysis through Braun and Clarke’s six-phased model (2006) was used to provide insight into their experiences.

FINDINGS: Substantial physical and new medical challenges existed for the participants and these had flow-on effects for their psychosocial wellbeing. Existing services were well regarded but the anticipated complexity of multi-specialists and continuing care provoked anxiety. Connection with others with similar challenges was seen as an important social resource.  

CONCLUSIONS: The complexities associated with an aging population of people with haemophilia has generated a need for a wide-range of services and supports. Social workers need to take new and different approaches to fill the roles of advocating for, educating and providing support to, older men with haemophilia.  


Allen, K., & Kachalsky, E. (2010). Aging with hemophilia: Implications for social work practice. Social Work in Health Care, 49(4), 327–344. doi:10.1080/00981380903520434

Barlow, J., Stapley, J., Ellard, D., & Gilchrist, M. (2007). Information and self‐management needs of people living with bleeding disorders: A survey. Haemophilia, 13(3), 264–270.

Bos, R. (2007). As haemophilia patients are aging... In E. Mauser-Bunschoten, A. De Knecht-Van Eekelen, & C. Smit (Eds.). Aging with haemophilia: Medical and psychological impact (pp. 87–93). Utrecht, Netherlands: Van Creveldkliniek-Haemotology.

Boult, C., Green, A. F., Boult, L. B., Pacala, J. T., Snyder, C., & Leff, B. (2009). Successful models of comprehensive care for older adults with chronic conditions: Evidence for the Institute of Medicine's “retooling for an aging America” report. Journal of the American Geriatrics Society, 57(12), 2328–2337.

Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101.

Cassis, F. (2007). Psychosocial care for people with Hemophilia. Montreal, Canada: World Federation of Hemophilia.

Chen, C., Huang, K., Chen, C., Huang, S., Huang, C., Chen, Y., & Hsu, S. (2015). The impact of joint range of motion limitations on health‐related quality of life in patients with haemophilia A: A prospective study. Haemophilia, 21(3), 176–184.

Corcoran, J., & Pillai, V. (2009). A review of the research on solution-focused therapy. British Journal of Social Work, 39(2), 234–242.

Dolan, G. (2010). The challenge of an ageing haemophilic population. Haemophilia, 16(5), 11–16.

Durie, M. (1985). A Māori perspective of health. Social Science & Medicine, 20(5), 483–486.

Franchini, M., & Mannucci, P. M. (2010). Co-morbidities and quality of life in elderly persons with haemophilia. British Journal of Haematology, 148(4), 522–533. doi:10.1111/j.1365-2141.2009.08005.x

Ghanizadeh, A., & Baligh-Jahromi, P. (2009). Depression, anxiety and suicidal behaviour in children and adolescents with Haemophilia. Haemophilia, 15(2), 528–532.

Heikkinen, E. (2006). Disability and physical activity in late life—Research models and approaches. European Review of Aging and Physical Activity, 3(1), 3–9.

Lambing, A., & Kachalsky, E. (2009). The new age of haemophilia. Haemophilia, 15(6), 1330–1331. doi:doi.org/10.1111/j.1365-2516.2009.02076.x

Lauzon, C. (2008). Still standing. Waiuku, New Zealand: W. J. Deed Printing.

Mannucci, P. M., Schutgens, R. E., Sant’agostino, E., & Mauser-Bunschoten, E. P. (2009). How I treat age-related morbidities in elderly persons with hemophilia. Blood, 114(26), 5256–5263.

Mauser-Bunschoten, E., De Knecht-Van Eekelen, A. & Smit, C. (2007). Aging with haemophilia: Medical and psychological impact. Utrecht, Netherlands: Van Creveldkliniek-Haemotology.

Meijer, K., & Van der meer, J. (2007). Invasive diagnostics and surgical interventions. In E. Mauser-Bunschoten, A. De Knecht-Van Eekelen, & C. Smit (Eds.), Aging with haemophilia: Medical and psychological impact (pp. 69-76). Utrecht, Netherlands: Van Creveldkliniek-Haemotology.

Nelson-Becker, H., Chapin, R., & Fast, B. (2013). The strengths model with older adults: Critical practice components. In D. Saleebey (Ed.), The strengths perspective in social work practice (6th ed., pp. 161–181). Boston, MA: Pearson.

Oldenburg, J., Dolan, G., & Lemm, G. (2009). Haemophilia care then, now and in the future. Haemophilia, 15, 2–7. doi:10.1111/j.1365-2516.2008.01946.x

Park, J., Scott, K., & Benseman, J. (1999). Dealing with a bleeding nuisance: A study of haemophilia care in New Zealand. The New Zealand Medical Journal, 112(1087), 155–158.

Park, J., Scott, K., Benseman, J., & Berry, E. (1995). A bleeding nuisance: Living with haemophilia in Aotearoa New Zealand. Auckland, NZ: Department of Anthropology, The University of Auckland.

Park, J., & York, D. (2008). Social ecology of new technologies and haemophilia in NZ—A bleeding nuisance revisited. Auckland, NZ: Department of Anthropology, The University of Auckland.

Pharmac. (2015). Inpharmation—August 2015. Retrieved from https://www.pharmac.govt.nz/newsletters/inpharmation/inpharmation-2015-08/

Rolstad, E. (2014). Perceptions of men with moderate to severe hemophilia regarding the management of their chronic disorder and utilization of community-based support. American Journal of Men’s Health, 9(6), 486–495. doi:10.1177/1557988314551360

Rosendaal, F. R., Smit, C., Varekamp, I., Brockervriends, A., Van Dijck, H., Suurmeijer, T. M., … Briët, E. (1990). Modern haemophilia treatment: Medical improvements and quality of life. Journal of Internal Medicine, 228(6), 633–640.

Street, A., Hill, K., Sussex, B., Warner, M., & Scully, M. F. (2006). Haemophilia and ageing. Haemophilia, 12, 8–12. doi:10.1111/j.1365-2516.2006.01254.x

Triemstra, A., Van der Ploeg, H., Smit, C., Briet, E., Ader, H., & Rosendaal, F. (1998). Well-being of haemophilia patients: A model for direct and indirect effects of medical parameters on the physical and psychosocial functioning. Social Science & Medicine, 47(5), 581–593.

Walter, M. (2006). Social research methods. Oxford, UK: Oxford University Press.

World Federation of Hemophilia. (2012). What is hemophilia? Retrieved from http://www.wfh.org/en/page.aspx?pid=646




How to Cite

Elliott, S. E., Deane, K. L., & Staniforth, B. (2017). A qualitative exploration of the unique challenges facing older men with haemophilia and the implications for social work practice. Aotearoa New Zealand Social Work, 29(2), 83–95. https://doi.org/10.11157/anzswj-vol29iss2id239



Original Articles